Deck 5: Procedural Coding

Question 1

A code in CPT that describes a procedure that is performed only in addition to a primary procedure is called a /an ___.

A) add-on code
B) supplement code
C) sub code
D) additional code

Answer 1

add-on code

Question 2

________ contains the standardized classification system for reporting medical procedures and services.

A) Current Coding Terminology
B) Current Procedural Terminology
C) Coding Procedural Guide
D) Coding Insurance Guide

Answer 2

Current Procedural Terminology

Question 3

A / An __ is one that identifies medical treatment or diagnostic services.

A) procedure code
B) diagnostic code
C) hospital code
D) classification code

Answer 3

procedure code

Question 4

Code Linkage is the ____.

A) connection between the EHR and the medical record
B) connection between the insurance record and the EHR
C) connection between the EHR and the PMR
D) connection between a service and a patient's condition or illness

Question 5

To ensure that the procedure codes, as well as the diagnosis codes, are correctly linked and valid, medical assistants should _____.

A) review the documents to be sure that it supports the codes
B) call the insurance company
C) consult with the physician
D) consult with the office manager

Question 6

_________ indicates a new procedure code.

A) A bullet
B) An asterisk
C) An ampersand
D) The letter P

Question 7

A / An _____ indicates that the code's descriptor has changed.

A) bracket
B) ampersand
C) letter C
D) triangle

Question 8

A plus sign (+) next to a code in the main text indicates _____.

A) an add-on code
B) an additional procedure is needed
C) an additional fee
D) an additional diagnosis is needed

Question 9

In CPT, a number appended to a code to report particular facts is called a (n) ____.

A) classification code
B) amended code
C) modifier
D) converter

Question 10

_____ are optional CPT codes that are used to track performance measures for a medical goal, such as reducing tobacco use.

A) Category I codes
B) Category II codes
C) Category III codes
D) Category IV codes

Question 11

A Category III code has a (n) ____ for the fifth digit.

A) number
B) special character
C) alphabetic character
D) number zero

Question 12

A / An _____ is the five-digit number to which one or more two-digit CPT modifiers may be assigned.

A) subterm
B) main number
C) supplementary term
D) primary integer

Question 13

When must a special report be attached to the health care claim?

A) when a specialist is consulted
B) when a code for an unlisted procedure is used
C) when the patient is a dependent
D) when there is more than one insurance company

Question 14

Unlisted procedures are ___.

A) elective services only
B) procedures done outside of the medical office
C) services not listed in CPT
D) procedures and services for dependents of policyholder Unlisted procedures are services not listed in CPT.

Question 15

The correct process for assigning accurate procedure codes has ____ steps.

A) four
B) six
C) eight
D) nine

Question 16

An administrative code indicating where medical services are provided is called ___.

A) place of service
B) locator code
C) global positioning code
D) site of service

Question 17

A service requested by the patient's physician that is performed by a second physician is known as a / an ______.

A) analysis
B) remedy
C) consultation
D) treatment

Question 18

What is the term for when a physician sends a patient to another physician for either total care or a specific portion of the care?

A) resettlement of patient
B) referral
C) professional courtesy
D) assignment of patient

Question 19

When determining the correct E/M code, the amount of work, time, and decision-making that was involved is called___.

A) level of service
B) estimation of service
C) amount of service
D) service charge

Question 20

Which of the following is not a key component that is used to determine level of service for E/M coding?

A) The extent of the patient history taken
B) The extent of the examination conducted
C) The complexity of the medical decision making
D) The attending physician

Question 21

_____ are factors that are found in the patient's medical record and used to determine the level of evaluation and management services.

A) key components
B) element components
C) division components
D) segment components

Question 22

_____ is a description of the development of the illness from the first sign or symptom that the patient experienced to the present time.

A) Patient Data
B) History of Present Illness
C) Physician Notations
D) Insurance Notations

Question 23

The ____ is an inventory of body systems.

A) patient data
B) medical history
C) vital signs
D) review of systems

Question 24

Codes in the surgery section that represent groups of procedures are called ___________.

A) code packages
B) surgical packages
C) code groupings
D) surgical groupings

Question 25

A procedure code for a surgical package that covers a group of services that should not also be listed individually is called a / an ___.

A) bundled code
B) cohesive code
C) interconnected code
D) related code

Question 26

To break a panel or package of services/procedures into component parts is an incorrect billing practice known as________.

A) dissemble
B) dissimulate
C) unbundle
D) suppress

Question 27

Unbundling causes ________.

A) decrease in fees
B) denied claims
C) increase in fees
D) loss of insurance

Question 28

The _____ includes the days surrounding a surgical procedure when all services relating to the procedure are considered part of the surgical package.

A) recovery time period
B) after care period
C) allotted time period
D) global period

Question 29

____ are codes for supplies and other items not included in CPT.

A) Health Care Common Procedure Coding System
B) Hospital Common Procedure Coding System
C) Health Care Collective Procedure Coding System
D) Hospital Corporate Procedure Coding System

Question 30

The HCPCS coding system has two levels, Level I codes from CPT and ___.

A) Level II codes issued by AARP
B) Level II codes issued by insurance companies
C) Level III codes issued by Medicare
D) Level II codes issued by CMS

Question 31

HCPCS is the abbreviation for ____.

A) Health Care Common Procedure Coding System
B) Hospital Common Procedure Code System
C) Health Common Practice Code System
D) Healthily Care Practice Code System

Question 32

The difference between a referral and a consultation is ____.

A) that in a referral, the primary physician sends the patient to another physician for health care.
B) that in a consultation, the patient is treated by a specialist.
C) a CPT code used for a consultation and ICD-10-CM for a referral
D) where the medical service is provided.

Question 33

On correct claims, each reported service is connected to what element that supports the medical necessity of the service?

A) diagnosis
B) chief complaint
C) secondary procedure
D) physician request number

Question 34

Under CPT guidelines, after a consultation, who takes responsibility for the patient's care?

A) the requesting physician
B) the consulting physician
C) the nurse practitioner
D) the surgeon

Question 35

Under CPT guidelines, services for follow-up care related to a surgical procedure are only reimbursed __________________.

A) before the global period
B) after the global period
C) during the global period
D) during the E/M period

Question 36

In CPT, a plus sign (+) next to a code indicates a (n) ____.

A) add-on code
B) new code
C) revised code
D) new text

Question 37

In CPT, a bullet (solid circle) next to a code indicates a (n) ____.

A) add-on code
B) new code
C) revised code
D) new/revised text

Question 38

In CPT, which term describes the number that is used to report special circumstances involved with a procedure or service?

A) referral
B) evaluation
C) modifier
D) consultation

Question 39

In a ____________________, the care of a patient is transferred from one physician to another physician.

A) referral
B) evaluation
C) management
D) consultation

Question 40

What is the correct CPT code for arthroplasty performed on the temporomandibular joint without autograft to remove bony ankylosis?

A) 21240
B) 21241
C) 21242
D) 21243

Question 41

What is the correct CPT code for routine cataract removal (extracapsular) with insertion of intraocular lens prosthesis (one-stage procedure), manual technique?

A) 66982
B) 66983
C) 66984
D) 66986

Question 42

What is the correct CPT code for magnetic resonance imaging (MRI) of a temporomandibular joint?

A) 70332
B) 70328
C) 70240
D) 70336

Question 43

What is the correct CPT code for the first hour of physician critical care of a patient in a coronary care unit who has gone into cardiac arrest?

A) 99289
B) 99290
C) 99291
D) 99292

Question 44

What is the correct CPT code for the history and examination of a healthy newborn girl admitted and discharged from the hospital on the same day?

A) 99463
B) 99411
C) 99441
D) 99460

Question 45

What is the correct CPT code for an excision of a small amount of back tissue (superficial biopsy) for sampling?

A) 21899
B) 21920
C) 21925
D) 21930

Question 46

What is the correct CPT code for diagnostic dilation and curettage?

A) 58100
B) 58140
C) 58150
D) 58120

Question 47

What is the correct CPT code for the initial office visit for evaluation of a 13-year-old male with progressive scoliosis, 30 minutes, detailed history and, examination, low-complexity of decision making?

A) 99201
B) 99202
C) 99203
D) 99204

Question 48

What is the correct CPT code for a repeat office visit with a 30-year-old male patient for a blood pressure check?

A) 99211
B) 99212
C) 99213
D) 99215

Question 49

What is the correct CPT code for the initial visit to a psychiatrist's office for a 15-year-old male patient who may be suicidal; the family is consulted; the history and examination are both comprehensive, and the decision-making is highly complex?

A) 99201
B) 99202
C) 99204
D) 99205

Question 50

What is the correct CPT code for a regularly scheduled follow-up fifteen-minute nursing home visit with a patient who has had a stroke?

A) 99307
B) 99212
C) 99213
D) 99304

Question 51

What is the correct CPT code for a repair of a diaphragmatic hernia, transthoracic?

A) 39501
B) 39503
C) 39520
D) 39530

Question 52

What is the correct CPT code for an unlisted procedure on the abdomen?

A) 39599
B) 29999
C) 39999
D) 43334

Question 53

What is the correct CPT code for a gastrostomy with construction of a gastric tube?

A) 43832
B) 43831
C) 43820
D) 43842

Question 54

What is the correct CPT code for a consultation provided by a rheumatologist for evaluation of a 58-year-old male patient with shoulder arthralgia; detailed history and, examination, and low complexity of medical decision-making?

A) 99241
B) 99242
C) 99243
D) 99244

Question 55

What is the correct CPT code for an initial consultation provided by a surgeon for a 42-year-old female patient who has been admitted to the hospital for rectal bleeding; problem focused history and, examination, and straightforward decision making?

A) 99251
B) 99252
C) 99254
D) 99255

Question 56

What is the correct CPT modifier for a staged or related procedure by the same physician during the postoperative period?

A) -22
B) -58
C) -59
D) -99

Question 57

What is the correct CPT modifier for minimal surgical assistant services?

A) -99
B) -88
C) -81
D) -59

Question 58

_____ is the practice of displaying the codes outside of numerical order in favor of grouping them according to the relationships among the code descriptions.

A) renumbering
B) relettering
C) resequencing
D) recoding